 
  <?php


$urlAction = 'pesanan/tambahPelanggan' ;


?>
 
 
 
 <div class="col-md-6">
<div class="box box-primary">
                                <div class="box-header">
                                    <h3 class="box-title">Form Pelanggan</h3>
                                </div><!-- /.box-header -->
                                <!-- form start -->
                                <form role="form" method="post" action="<?php echo base_url() . $urlAction ; ?>">
                                    <div class="box-body">
									
									 
										<div class="form-group">
                                            <label >No Identitas</label>
                                            <input type="text" class="form-control" value="" name="identitas" id="wilayah" placeholder="Masukan ID Konsumen">
                                        </div>	
														
							<div class="form-group">
                                            <label >Nama</label>
                                            <input type="text" class="form-control" value="" name="nama" id="wilayah" placeholder="masukkan nama">
                                        </div>	

							<div class="form-group">
                                            <label >Masukan Alamat</label>
                                            <textarea name="alamat"  class="form-control" >  </textarea>
                                        </div>	

							<div class="form-group">
                                            <label >Kecamatan</label>
                                            <input type="text" class="form-control" value="" name="kecamatan" id="wilayah" placeholder="masukkan kecamatan">
                                        </div>	

							<div class="form-group">
                                            <label >No Telepon</label>
                                            <input type="text" class="form-control" value="" name="no_telepon" id="wilayah" placeholder="masukkan nomer telepon konsumen">
                                        </div>	

							<div class="form-group">
                                            <label >Cabang</label>
                                            <input type="text" class="form-control" value="" name="cabang" id="wilayah" placeholder="masukkan cabang">
                                        </div>											

									
							
										
                                    </div><!-- /.box-body -->

                                    <div class="box-footer">
                                        <button type="submit" class="btn btn-primary">Submit</button>
										  <a href="<?php echo base_url()?>pesanan/daftar_pesanan"><i name="iconposition" class="btn btn-success" title='Kembali' alt='Kembali'   > Kembali</i></a>
                                    </div>
                                </form>
                            </div><!-- /.box -->
 </div>